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Effects of Povidone-iodine Dissolved in the Cornea Storage Media on Endothelial Cell Health
Betadine, Cornea, Endothelium, Povidone Iodine
Introduction: Fungal keratitis and endophthalmitis are uncommon but devastating complications of corneal transplants, however no current FDA-approved cornea storage media contain antifungal coverage.
Objectives: To examine the effects of various concentrations of povidone-iodine (PI) dissolved in cornea storage media on endothelial cell health.
Methods: Donor corneas deemed fit for research but unfit for transplant were examined with light microscopy and 14 corneas of high quality were chosen for inclusion. Optisol GS was used as the cornea storage media. Two corneas were randomly selected as controls, and the remaining 12 were evenly distributed among four different concentrations of PI obtained through serial dilutions of an original 10% PI solution. Backlight microscopy12 and specular microscopy were obtained and compared with similar studies performed at 24 hours, 48 hours, and 7 days following placement of the corneas in the PI solutions.
Results: Specular microscopy of all four PI concentrations tested was unable to detect individual endothelial cells as a result of PI toxicity. Significant corneal haze developed in all four concentrations as early as the 24 hour mark. Betadine crystals were noted on both backlight microscopy and specular microscopy in the 1% PI and 0.75% PI specimens.
Conclusions: Although povidone-iodine may be safe and effective at decreasing fungal contamination, the toxicity of this medication to the corneal endothelium as noted in this study indicates that it is not a safe additive to cornea storage media.